The following article describes a lawsuit in Lille against an ABA practitioner with the clear goal to close the only university program in ABA in France and to attack ABA after the recommendations of March 2012 favoring ABA against psychoanalysis in the treatment of children with autism in France.
Translation thanks to Karen Wilshin
By Sophie Dufau -Mediapart.fr
The treatment of autistic children in the North of France, using the methods of Vinca Rivière, is far from the fairy tale that the university lecturer likes to present it as. Following the report of the regional health agency, which in answer to a letter from parents, concluded that in the Camus center there were“malfunctions” which constitute “abuse risk factors likely to have repercussions on the children at the center.” (see the revelations in Mediapart), a civil court case is being prepared for the autumn for “unfair practices by Vinca Rivière and her association Pas-à-Pas (Step by Step) and failure to fulfill their contractual obligations” in the home therapy of a child. In other words, to hear this family’s story: poor treatments and incompetent personnel.
Jacques Turan, the child’s father is not bringing this case “for the money” — the parents are only asking for €5,000, far from the sums already paid out, and which, if they win, will be given to an autism therapy association —” It’s simply to denounce the total disregard she had for our child: she treated him like a Kleenex, she had no scruples in excluding him. We didn’t want to leave with this feeling of impunity. And we hope that by telling our story that other parents will benefit.”
To understand what is at stake in this case, it is important to remember that Vinca Rivière is a leading light in the world of autism. In charge of the masters and diploma course at Lille 3 university, she claims to have introduced ABA — Applied Behavior Analysis, —, to France, a behavioral learning method which, last March, was classified by the National Authority for Health among the “recommended interventions” in the treatment of people with pervasive development disorders (PDD).
Even if many professionals contest Vinca Rivière’s title of pioneer, even if the unique association to which she claims to belong, the “Federation for the development of behavioral sciences, which groups 12 national and 2 international associations” was created by her in 2009, the media still turn toVinca Rivière to illustrate the new therapies for autism. The public no doubt remember her appearance on the national tv channel France 2 in June 2008, when the actor Francis Perrin gave her carte blanche in the “Envoyé Special” program to present the method and the professionals who were taking care of his son Louis.
In our investigation last April, other than the fact that for certain adult patients, Vinca Rivière defended “punishment by electric shock”, we also revealed that, boosted by the letter of support she had obtained from Xavier Bertrand, the Camus center, which she had opened in 2008, had received a budget from the health ministry of more than 80,000 Euros per child per year, 2.5 times more than other, similar centers in France.
It is in this context that the letters and complaints from parents take on their full meaning.
Always more money
In Roubaix, Vinca Rivière is in charge of two structures: the association Pas-à-Pas, which she created shortly after the year 2000 (of which she is currently the treasurer) to provide home treatment for children, and the Camus center, opened in 2008, which is managed by the Pas-à-Pas association. Today there are 20 children in the center and 80 in the association.
Jacques Turan first crossed Vinca Rivière’s path around 2005.
At the end of 2006, he signed up for the university diploma she runs at Lille 3. At that time he was a doctor in the Franche-Comté region. His son, who was 6 at the time was non-verbal, not toilet-trained and was receiving no particular therapy. The father hoped that these monthly trips between Vesoul and Lille would enable him to meet ABA psychologists who might want to set up practice in Eastern France. But Vinca Rivière assured me that if we came to Lille, Zacharie could have 40 hours of home therapy a week. In April 2007, the psychologist with whom he had been put in contact assured him that “everything is in place for Zacharie.” and “we must not wait any longer. At 6 years old, she told us, every day counts. We should come as soon as we could. It was verging on harassment.”
Even though the association had made no diagnosis of the child, relying solely on his father’s account to evaluate his needs, the Turans decided to commit themselves. Overnight, they left Franche-Comté, sold the house “that we had had built“, and ended “the relationship with the medical practice where I worked.“ Faced with the lack of treatments for their autistic child, every opportunity presented to them was a chance to keep moving forward.
Imagine their surprise when, on arriving in Lille, “there was no team, just a newly-qualified student, incapable of drawing up or modeling a program in accordance with the child’s development, and another in their 4thyear of studies.” says the father. The mother continues: “From the start many things were not right: the psychologist was completely wide of the mark, vague and evasive. She rushed through the test of Zacharie’s abilities. In all the autism resource centers, this test is followed by a written report; we had already had one in Strasbourg. But when I asked for it, she told me that it “was not how she worked” and that she would give a verbal report. Don’t forget that we had paid 545 Euros…”
Vinca Rivière then came to their house for a discussion. The parents not only asked for a written report of the test, but also a report on Zacharie’s sessions with the psychologist and therapist. “Not at the end of each session, explains the father, but once a week, twice a month even, just something outlining the program and any progress. ”
Whereas they expected to have access to experienced staff when they arrived at Lille, it quickly became apparent for the parents that they were in fact dealing with students. “They were paid with employment service vouchers: 12€ net per hour for those in Masters 2; 10€ for those in Masters 1, and 8€ for those studying for a degree.” A psychologist was there to supervise the therapists, like a continuing education program. We had agreed at the start that Zacharie would receive 40 hours of home therapy, and that the psychologist would bill us an additional 10 hours of supervision. ”
But faced with the difficulties the therapists were having, the psychologist had only one solution: “When things were not going well with this one or that one, they had to be supervised. It was always more supervision, costing 35€ an hour, so always more and more money. Or she would propose to provide the therapy herself, at a cost of 25€ an hour, which we had not budgeted for at all explains Zakia Turan. On average, this therapy cost them around 2,000 euros a month.
It has to be said that the professionals were quite offhand about the program. Just as an example: once Zacharie was toilet trained during the day, the mother asked about the program for getting him dry at night. “Wake him up every 10 minutes” replied the psychologist. “I thought she was joking, but she was absolutely serious, remembers the mother. You don’t need to be a great psychologist to understand that’s total rubbish. In fact, I just stopped putting a diaper on Zacharie, there was no problem, and that was it, he was dry at night. ”
Four months after the start of the therapy, and faced with the demands and the doubts of the parents who could see their son developing new behaviors, Vinca Rivière once again came to their home. She promised new therapists and “you’ll see, Zacharie will be speaking within the year.” She assured them that as soon as the Camus center had opened, there would be a place for Zacharie. In reality, the therapy did improve slightly and Zacharie made some progress.
They managed to film a session (although the therapist always had an excuse for not using the camera whose films were supposed to be used for supervisions): “You can see Zacharie who was restless, the therapist takes her place. Zacharie was supposed to put down a token, so she pushed his hand, violently. She is really angry, you can see it in her face, she’s having difficulty in controlling herself. For me, it’s child abuse“, says his mother, who goes on: “Before, Zacharie was a calm and gentle child. But now we are faced with a child who gets angry and who can’t stand the slightest frustration. He urinated and defecated everywhere, even though he had been dry day and night. When he saw the team arrive, he raised his hands to his face, as if he was frightened of being hit. He became a frightened animal. You can see it in the videos. ”
The therapist was removed and the therapy stopped. In June 2008, “as we no longer had anyone, we agreed that a first-year student would come and go bike-riding with Zacharie. Clearly they were incapable of doing more“, remembers his mother.
Letters to Xavier Bertrand and François Fillon
Their ordeal continued the following autumn. Constantly-changing psychologists and therapists, appointments not respected, lies… all of which came out in our previous investigation prior to the report by the regional health authority. “We got the impression that Vinca Rivière was using the parents to evaluate her students. As soon as she was happy with one of them, they were taken away from home therapy and used in the center. When it wasn’t simply the personnel who resigned, weighed down by “pressure or by things they were unable to accept” as one student confided in them. The Turans estimate to have seen around twenty therapists, not counting the student observers.
Even worse, they feel they were deliberately cut off. Far from their family and friends left behind in Franche-Comté, they were never put in contact with other families. Vinca Rivière also refused the presence of an occupational therapist or speech therapist, both of which Zacharie had used in Franche-Comté. She was lukewarm at the idea the parents were going crazy trying to get their child into school three half-days a week. “Vinca Rivière in fact refuses anything which might examine her working method, everything which might interfere with what she is doing. She uses people’s distress, tries to turn parents against each other. I’m not challenging ABA, just the way this association is organized. ”
At the end of 2008, eighteen months after leaving Franche-Comté, Jacques Turan approached professors at Lille university, “for a discussion, to find out what was being done in the region.” The psychologist and Vinca Rivière accused us of looking for other centers, other therapists, and of being over-involved in our child’s treatment. From that moment on, “it stopped dead. We were told: “we’ll find a solution”, but they didn’t bother. ”
The parents were presented with a paper to say that they were stopping the therapy. “We didn’t want to sign it. It wasn’t our decision, just a way for Vinca Rivière to get out of her responsibilities. The psychologist, who they had been able to contact at any time now switched off her cell phone at 6pm. Vinca Rivière stopped replying to e-mails. One day, one of the therapists came to the house to collect the camera used for supervision, claiming that they needed it and would bring it back in two days. Two days later, it was a recorded delivery letter that arrived, just a note with “the addresses of two associations and basically get on with it. They dropped us. Zacharie stayed at home, with nothing, for three months.” And then of course came the letters demanding payment.
So the parents tried to raise the alarm. They sent letters to the National Authority for Health, to the Health Minister at the time, Xavier Bertrand, to François Fillon the Prime Minister and to the University at Lille 3. In vain. All they received was the support of a few professors, including Claude Bursztejn, a psychiatrist and president of the National Association of Autism Resource Centers, “who notwithstanding any theoretical or ideological reference” said he was “shocked from an ethical point of view.”
In 2009 therefore, they turned to justice. it took several months for the court-appointed officer to serve the assignation on Vinca Rivière. At Lille 3 university, no-one was able to say where her office was, nor where and when she would be teaching, says the father, still amazed to this day. So I gave the court officer a photo so that if he saw her, he could give her the envelope. ”
Today, the Turans live near Paris. Zacharie attends a center run by the association “Agir et Vaincre” (“Act and Defeat”) whose multi-disciplinary team specializes in ABA. “We wasted 2 years, and 2 years in the life of an autistic child is enormous. ”
The hearing, delayed many times, should now take place in the autumn. Vinca Rivière has new legal counsel. Gilbert Collard, who previously defended her has just started a new career as an elected representative, under the colors of the National Front.